Varady Nathan H, Bram Joshua T, Chow Jarred, Taylor Samuel A, Dines Joshua S, Fu Michael C, Ode Gabriella E, Dines David M, Gulotta Lawrence V, Brusalis Christopher M
Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, NY, USA.
Weill Cornell Medical College, New York, NY, USA.
J Shoulder Elbow Surg. 2025 Feb;34(2):639-649. doi: 10.1016/j.jse.2024.08.020. Epub 2024 Oct 9.
Glenoid version is a critical anatomic parameter relied upon by many surgeons to inform preoperative planning for shoulder arthroplasty. Advancements in imaging technology have prompted measurements of glenoid version on various imaging modalities with different techniques. However, discrepancies in how glenoid version is measured within the literature have not been well characterized.
A literature search was performed by querying PubMed, EMBASE, CINAHL, and Cochrane computerized databases from their inception through December 2023 to identify studies that assessed the relationship between preoperative glenoid version and at least one clinical or radiologic outcome following shoulder arthroplasty. Study quality was assessed via the Methodologic Index for Nonrandomized Studies criteria. Imaging modalities and techniques for measuring glenoid version, along with their association with clinical outcomes, were aggregated.
Among 61 studies encompassing 17,070 shoulder arthroplasties, 27 studies (44.3%) described explicitly how glenoid version was measured. The most common imaging modality to assess preoperative glenoid version was computed tomography (CT) (63.9%), followed by radiography (23%); 11.5% of studies used a combination of imaging modalities within their study cohort. Among the studies using CT, 56.5% utilized two-dimensional (2D) CT, 41.3% utilized three-dimensional (3D) CT, and 2.2% used a combination of 2D and 3D CT. The use of 3D CT increased from 12.5% of studies in 2012-2014 to 25% of studies in 2018-2020 to 52% of studies in 2021-2023 (p = 0.02). Forty-three (70.5%) studies measured postoperative version, most commonly on axillary radiograph (22 [51.2%]); 34.9% of these studies used different imaging modalities to assess pre- and postoperative version.
This systematic review revealed marked discrepancies in how glenoid version was measured and reported in studies pertaining to shoulder arthroplasty. A temporal trend of increased utilization of 3D CT scans and commercial preoperative planning software was identified. Improved standardization of the imaging modality and technique for measuring glenoid version will enable more rigorous evaluation of its impact on clinical outcomes.
肩胛盂方向是许多外科医生在进行肩关节置换术前规划时所依赖的关键解剖参数。成像技术的进步促使人们采用不同技术在各种成像方式上测量肩胛盂方向。然而，文献中关于肩胛盂方向测量方法的差异尚未得到充分描述。
通过检索PubMed、EMBASE、CINAHL和Cochrane计算机数据库，从其创建到2023年12月，以确定评估肩关节置换术前肩胛盂方向与至少一项临床或放射学结果之间关系的研究。研究质量通过非随机研究方法学指数标准进行评估。汇总了测量肩胛盂方向的成像方式和技术，以及它们与临床结果的关联。
在涵盖17070例肩关节置换术的61项研究中，27项研究（44.3%）明确描述了肩胛盂方向的测量方法。评估术前肩胛盂方向最常用的成像方式是计算机断层扫描（CT）（63.9%），其次是X线摄影（23%）；11.5%的研究在其研究队列中使用了多种成像方式的组合。在使用CT的研究中，56.5%采用二维（2D）CT，41.3%采用三维（3D）CT，2.2%同时使用2D和3D CT。3D CT的使用比例从2012 - 2014年研究的12.5%增加到2018 - 2020年研究的25%，再到2021 - 2023年研究的52%（p = 0.02）。43项研究（占70.5%）测量了术后方向，最常见的是在腋位X线片上测量（22项[占51.2%]）；这些研究中有34.9%使用不同的成像方式评估术前和术后方向。
本系统评价揭示了在肩关节置换术相关研究中，肩胛盂方向的测量和报告方式存在显著差异。确定了3D CT扫描和商业术前规划软件使用增加的时间趋势。改进测量肩胛盂方向的成像方式和技术的标准化，将能够更严格地评估其对临床结果的影响。
